Surgical Penis Enlargement Mini Forum ~ Penis surgery

BG, I think the thread is back on course. Stmheath seems to be suggesting simply that fat lost via pubic liposuction can be gained back easily. I don’t know if that’s true, but I’m curious what Crash’s experience has been.

Wow, while we sleep…Xefon,The choice of the surgeon to put off lipo for you is most likely to avoid a higher risk of complications due to being over weight. This could be a number of things such as poor circulation, and decreased healing capacity. Cosmetic surgery can only take you so far, there only allowed by law to lipo a given amount per session. If you lost more weight on your own, which you seem to be on the right track, lipo will be more effective and safer also.

Prodigal son,A combined price for length, girth, glands, is about $8500-$13,000 on average amongst the phallo surgeons I’m aware of.

Forum, Without having its own forum it is very hard to control tangents that do not pertain to the subject at hand. Please refrain from subjects that do not belong with my intentions. Thank you,Crash

For girth the procedures have been pretty similiar. Some sort of graft or analogous tranfer was performed. This technique surgically splits the tunica. The tunica has been discussed to exaustion as being a limiting factor to girth gains. My concerns with this procedure would be loss of sensation, a ban of scar tissue easily felt under the skin, weak erections. What are some of your opinions to the effectiveness of such a procedure and possible downfalls?

I remember reading an article in a magazine about 10 years ago about a doc that performed enlargement surgery without implanting any substance, so I think this could be the same surgery as Lee Hang-Fu. I think his name was Dr Roo. Also the surgey was carried while the patient was under general anesthetic but with an injection induced erection.

06-11-2005, 03:52 AM

crashhex

Harold Reed is a leader in the field of genital reasignment surgery, operating on the most complex cases of genital surgery, as you could imagine. He is also a very respected phalloplastic surgeon, and I trust his skill. This is an informative article on penile girth enhancements. He does not perform Free fat Transfer, but only explains the procedure.

A. Liposuctioned fat is removed by cannula from thesuprapubic area, or if need be the lower abdomen orbuttocks. Up to 60 cc (2 ounces) of fat is distributedsubcutaneously to provide ultimately a 1” gain incircumference. After the liposuctioned fat isinjected, it is then molded cylindrically by thesurgeon’s hands.

The sites of fat aspiration being rather small healinconspicuously as does the injection site. Theadvantage of this approach is that the procedure canbe done in somewhat under an hour and is comparativelyeconomical. The disadvantages are possible loss of fatand the formation of lumps under the skin. Thelikelihood that significant loss or lumps could occuris about 50%. Followup care for 2 years is included,should there be contour deviations greater than 1/8”.

Thoughts to keep in mind:

1. Following aspirated fatgrafting, the penis will be swollen for a while. Whenthe swelling subsides,some patients think they have lost fat. Our goal is toprovide a 1 inch increase in circumference over thebaseline.

2. Although autologous fat grafting to otherparts of the body has been reported for decades and ispracticed widely, penile transfer has only been donefor about 8 years.

3. No sex for 5 to 6 weeks sothat the fat can become fixated to the surroundingtissues.

For this reason, circumcision as an independentprocedure is recommended first, so the fat can beplaced all the way distally on the shaft.

5. In thatthe glans (head of the penis) is not increased by thisprocess, too much fat will produce the “wiener in thebun” look.

6. Too much fat will also cause the opticalillusion of a shorter penis, because any object thatbecomes wider without increase in length will seemshorter.

7. Casualpalpatation of the penis following girth enhancementwill not disclose any appreciable change in texture,and erections will remain firm to tense.

8. Occasionally the contour line may be altered byreabsorption or aggregation of fat. This has happenedless frequently as patients are now advised to wearloose fitting clothing and not to “fold” their penisesduring the first few weeks after surgery. If thisappearance is not acceptable, a lump can be easilytrimmed or a defect brought up to grade with a littlelocal anesthetic after 3 months.

9. This is not a recommended procedure forpatients with retractile penises (that is patientswith reasonably adequate erect length, but who havevery short flaccid length). Fat is inserted with thepenis on the stretch, so the very act of retractiondisperses and redistributes the fat in a mostunappreciated manner.

since the first procedure performed over 8 years ago,close to 10,000 patients (not all mine) have hadautologous fat transfer to the penis with varyingresults. Experience has confirmed the dictum” less ismore.” The end result is more natural. Transferred fatthat has earned its right of domicile (say 6 weekspost surgery) and is viable, remains durable and doesnot melt away with sexual intercourse.

B. Dermal fat strips are harvested from the upperposterior thigh(one strip from either side) and the incision isclosed mainly in the infragluteal crease line belowthe buttocks or one long strip from the lowerabdominal area. These infra gluteal strips aretypically 1 inch high and 5 to 7 inches long. Thedistal ends of the graft are sutured under the rim ofthe head which flares the head somewhat. The skin onthe top side of the penis is undermined and the stripspassed into the pubic area. The incisions are thenclosed carefully. The advantage of this approach isminimal to no absorption and typically no lumps.Because this procedure is more involved, the operatingtime runs 2 to 3 hours. Installing anoverly thick strip will compress circulation. Ouroffice strongly advises that should you elect penilelengthening and strips, that these procedures bestaged. Allow for a 4 to 6 month waitingperiod after lengthening to get the added lengthpenile traction provides. Grafts survive better whenthe incisions are morelimited and the host tissue is in close apposition to(hugs) the graft. Dermal grafts notoriously docontract initially for 2 to 3 months and then elongatewith erectile activity and gentle massage.Before & after photographs are available for viewingon the internet (PENISDOCTOR.COM) and upon yourinitial consultation.

C. AlloDerm is a donated dermal tiss_e product ofLifeCell Corporation. During the manufacturing processcells are removed leaving in essence a connectivetissue matrix. When implanted under the skin your bodycells grow into the matrix providing addedgirth. AlloDerm is FDA approved and has been in usesince 1992. Typically AlloDerm has been used toenhance lips of models, build up facial deformities,replace skin loss and cover raw surfaces.

AlloDerm grafts can be folded, rolled or stacked toprovide the amount of tissue needed. There has neverbeen a documented case of HIV transmission or allergicreaction from the transplant of any freeze-dried,processed tissue graft. More than 25,000 patientshave received AlloDerm grafts. The advantage ofAlloDerm is the avoidance of harvesting incisions.With time the eventual reabsorption of the matrixleaves behind only the patient’s newly generated softtissue. Experience with Alloderm in the penis islimited and is in clinical trial at this time.Surgical fee: $6,000.

For more information on AlloDerm you may contact ouroffice or write to LifeCell Corporation at 3606Research Forest Drive, The Woodlands, Texas 77381 orcall 1-800-367-5737.

Testicular Enhancement: Traditionally when a testiclehas atrophied or surgical removal has beennecessitated, a soft silicone prosthesis can beinserted as a replacement which is of full size andfeels very much like the real thing. While I certainlydo notrecommend removal of small but functioning testes,their size can be enhanced with a crescentic siliconemold that covers the front and sides of the actualtesticle like a cap. At this time we have done closeto 30 cases, (42 testicular prostheses implanted) andthere have been absolutely no complications except forone patient who truly needed a larger size. Allpatients are pleased. However risks generic to allincisions include wound infection, separation of theincisionalline, pain, numbness, and bleeding into thewound site. The effects on fertility are not knownalthough the spermatic duct is not transected insurgery.

Patients contemplating fatherhood at any time in thefuture are discouraged from having the procedureperformed, until more is learned regarding the effectson fertility. Our office will pay for any patient tohave a seminal analysis when scheduling surgery withthe understanding that 6 months later another seminalanalysis will be performed “gratis” for comparison.Surgical fee: $3850.

Foreskin Restoration performed surgically is a 2stage procedure.(There are non surgical methods reported on theinternet related to prolonged skin stretching). In thefirst stage a tissue expander is placed under theproximal penile shaft skin. New penile skin is createdby periodically filling the expander with sterilesolution.

After a 2 month period, 5 ounces of fluid arecontained within. In the second stage the expander isremoved, the mid and distal shaft skin is transferredover the head to create a neo-foreskin. The deficit ofskin in the midshaft is replaced by a flap of theexpanded skin from the base. As this procedurerequires closedoctor-patient rapport and follow up visits whenconcerns present, due consideration must be givenbeforehand. Risks include tissue necrosis, woundinfection, separation of incisional lines,paraphimosis, and failure to completely cover theglans. Surgical fee: $6000.

"Crazy dancin! Making my penis sore!"

- Dave Chapelle

06-11-2005, 03:59 AM

crashhex

This is an article written by Douglas Whitehead MD, regarding the lengthening procedure and how it has evolved.

Every cosmetic surgeon, be he a urologist or a plasticsurgeon, is interested in the final cosmeticappearance of his surgical procedure. Similarly, thepatient is interested in a cosmetically pleasingincision. As a result, cosmetic surgeons try to makeincisions in natural skin lines so that the incisionsare concealed as much as possible.

Additionally, an incisioncan be concealed by naturally located hair, such asthe pubic hair, and as a result, the incision will beless noticeable. Cosmetic surgeons also use suturesand surgical techniques that will tend to give apleasing cosmetic result. A selection of suturematerials exists as well as types of suture placement.Your surgeon will make the best selection using hisskill and past experience to produce a pleasingresult.

Over the years numerous types of incisions for penilelengthening have been used. These are made in theinfrapubic region (lower abdominal area), just abovewhere the penis meets the body. These incisions have beencalled by names representing their appearance, such asthe M-plasty, Zplasty, ZZ-plasty, V-Y-plasty,transverse incision, longitudinal incision andcurvilinear incision. The M-plasty, Z-plasty,ZZ-plasty, V-Y-plasty incisions actually create skinflaps intended to cover the base of the penis at thejunction of the abdomen and penis where the erectilechambers have been advanced outwards.

While any incision can “open” (dehisce) and skinbreakdown can occur even when such efforts as takingof Vitamin C or cessation of smoking are employed,these problems are much more likely after Z-plasty,M-plasty, and small V-Y-plasty incisions. There arealso other problems associated with these infrapubicskin flaps, such as scrotalization (where the scrotalskin appears at the base of the penis). This may beseen with large V-Yplasty incisions. Additionally,dorsal humps may form with the V-Y-plasty incision dueto thick skin and hair being placed at the base of thepenis, particularly if the incision extends to thepenile shaft. Longitudinal infrapubic incisions shouldnot be used because, during healing, normalcontracture of the incision will tend to shorten thepenis and may impair blood flow and sensation on theother side of the incision. All incisions have thepotential for developing a thick scar (hypertrophy),incisional pain and infection; and a cutaneous (skin)scar contracture, and subcutaneous (under the skin)deep adhesion might result in shortening of the penis.

Sometimes revision surgery or injection treatment fora hypertrophic scar or cutaneous or deep contractureis necessary. Scar revision surgery is possible and inmany cases will produce a satisfactory result withoutcompromise of the penile lengthening that has alreadybeen performed. For those patients who wish scar ordeep contracture correction without surgery, various softening treatments are available usingsteroids or other medications combined with a painmedication given by injection into the lesion forseveral months combined with physiotherapy using agentle pulling motion of the head of the penis and/orpenile weights during the period that the injectionsare given. My favorite regimen for softening suchlesions uses Verapamil and Lidocaine weekly for threemonths, starting approximately six to eight weeksafter the surgery, or as soon as such a problem isnoted. Some physicians use a powder of Vitamin E (400 IU,three or four times a day) to prevent these problems;and some physicians inject medication into thesurgical site in the hope of preventing deepcontractures.

Recently, skin flaps have fallen into disfavor andmany urologists and plastic surgeons no longer usethem because of the problems described above, andbecause often the infrapubic skin is not advanceableto the penis, but just advances the flap to a slightly lowerpart of the abdomen unless extensive incisions aremade on the base and sides of the penis, which thenresults in significant hair being advanced onto theshaft.

Another reason why skin flaps have fallen intodisfavor is the belief thatthe skin is not the limiting factor for penile length,but rather the limiting factors are: subcutaneous anddeep adhesions, failure to use penileweights, failure to close the “dead” space at surgery,and lack of frequent erections. As a result, mosturologists and plastic surgeons now prefer atransverse incision or a curvilinear incision.

My preferred incisions for penile lengthening

Transverse or curvilinear infrapubic incisionMost surgeons now prefer a transverse or curvilinearinfrapubic incision. With a meticulous three-layerskin closure early use of penile weights can beemployed if there is no skin tethering of thepeno-pubic skin angle. If tethering is present, peniletension with early use of weights would tend to openup the incision.

Scrotal incision

I have recently adopted a technique that does not usea penile or abdominal incision for penile lengthening.By using a midline scrotal raphe incision (the naturalline on the front of the scrotum) or a superiorlateral incision (on the upper side of the scrotum) itis possible to divide the suspensory ligament and thefundiform ligaments. While this is a technically moredifficult operation for the surgeon, it eliminatesalmost all of the potential complications indicatedabove, and after a few months this incision iscompletely unnoticeable. Furthermore, it allows use ofpenile weights three to five days after surgery. Useof penile weights as early as this is desirable andwould tend to prevent shortening of the penis due todeep adhesions (contractures) or incision contractureand will maintain the length gain obtained at surgery.

"Crazy dancin! Making my penis sore!"

- Dave Chapelle

06-11-2005, 04:32 AM

xefon

This is the thing about the Lipo, You are born with a set number of fat cells that number NEVER increases they just expand or contract If you remove the fat cells they cant come back, Although the ones you have left can expand, But for someone like me Removing that little bit of fat would help with self conciseness.

Crash, did they do the lipo from the opening that they did the lig cut from or did they put more holes in you?

This is the thing about the Lipo, You are born with a set number of fat cells that number NEVER increases they just expand or contract If you remove the fat cells they cant come back, Although the ones you have left can expand, But for someone like me Removing that little bit of fat would help with self conciseness.

Crash, did they do the lipo from the opening that they did the lig cut from or did they put more holes in you?

Well, I was sleeping at the time. I didn’t wake up with any little holes until I got back home. I assume that they used the incision at the base of my penis. There is a pretty good photo where you can see the lipo effect, here’s the link.

Crashhex invited me to share my experience as well — I underwent girth enlargment procedures in July 2002 and November 2004. I gained approximately 1” in girth both times, bringing me to just under 7.5” around today — which is quite a jaw-breaker, though not impossibly so.

In both cases, the procedure was quick and relatively painless; the healing time was much longer the first time than the second, even though I tried to follow the doctor’s instructions to the letter both times.

For me the pros are obvious — I love the size, I enjoy showing it off, and that translates into more self-confidence ‘in the boudoir’. Some of the drawbacks are that I have to be a little more conscientious about how I dress for work, and that some people are turned-off by the appearance (someone on here once called me “ugly and unnatural” — but I lived with a ‘pretty’ dick for 33 years and now I have a big one instead. ;) )

06-11-2005, 03:35 PM

crashhex

mindseye,What procedure was used for your girth? Where did you have it done? How much was the cost? What have been some of the reactions of the ladies? I appreciate your contribution. Is there anything that you have learned from this experience that you would avoid in hindsight?I appreciate your contribution. Here’s the link with photo evidence mindseye posted.

Mindseye, those are some nice previous pics

I’ve got a ton of questions if you got a the time!

What is your BPEL and how much did the silicone surgery cost? At this point, do you still feel your erect state feels totally natural and hard as it was before? Does the silicone move around? Do you still do PE with the silicone implants for girth?

06-14-2005, 12:20 AM

mindseye

Crashhex wrote:

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What procedure was used for your girth?

Silicone injections; I’ve had a total of 500cc injected. 250cc in the shaft, and 250cc in the scrotum. (By comparison, a can of soda is 355cc.)

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Where did you have it done?

Mexico; the procedure is not currently approved in the US (there are people who’ll do it, but I preferred to have mine done by a real doctor, just in case).

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How much was the cost?

$1500, plus airfare and hotel.

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What have been some of the reactions of the ladies?

I’d have to say that the most common reaction I get from other guys is an open-minded curiosity along the lines of, “wow, that’d kind of cool, but I’d never go through with it myself.” Of course, I get a few reactions that are more extreme (both negative and positive).

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Is there anything that you have learned from this experience that you would avoid in hindsight?

Gosh, I don’t learn from my experiences. :) Overall, I’m happy with the outcome — I used to wear a PA, so I was already accustomed to the fact that some people might respond negatively; I’ve gotten pretty good at ‘screening’ those people out. I wouldn’t recommend it as a shortcut to natural PE, though, if you want to keep your ‘look’.

Chitownstud4u wrote:

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What is your BPEL?

About 5.75” (though I generally round up to 6 online. ;) ), $1500.

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At this point, do you still feel your erect state feels totally natural and hard as it was before?

I can feel a little difference right at the injection site, but it’s not something that other people are likely to notice. For guys who get a lot of silicone, so that there’s more silicone than dick, the erections start to feel like they’re wrapped in ‘Nerf’ — a little spongy on the outside. The silicone doesn’t ever enter the corpora cavernosa, so the actual erection is unchanged.

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Does the silicone move around?

For a few days after surgery, the silicone is fluid — and the doctor will discuss this and the aftercare required. After a couple of days, the silicone settles into place and ‘bonds’ itself to your tissue. (It actually does ‘bond’ to you, making removal difficult later on.)

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Do you still do PE with the silicone implants for girth?

Eh, off and on. I’ll confess that I’m not as diligent as most of the members here (I admire those of you who can stick to a program and see results!) — but I still do some PE.

06-14-2005, 06:11 AM

viva_la_rev

I’m having a real hard time deciding what to go with, Silicone done in Mexico, Dermal Fat Grafts done by this guy “penisdoctor.com” in Florida or maybe the Alloderm grafting by maybe Dr. Whitehead.

The Silicone is by far the cheapest and seems to be quite effective too, the Fat grafts are apealing to me because it’s my own body tissue being utilized and the Alloderm grafts seem to be the “most” effective, in regards to permenance and texture.

However, the Silicone is probably more risky and artificial, the Fat grafts may not be as effective as the Alloderm grafts, and honestly, the Alloderm grafts are a bit nasty considering they’re harvested from dead people.

I’m leaning on the Silicone injection, I know you’ll all be surprised by that but, there’s nothing in Mexian blood that makes them less compitent.

What do you all think? Fat graft seems nice too.

06-14-2005, 07:00 AM

mindseye

Fat grafting will cost you more for the same amount of gains, and there’s a risk of reabsorption that’s not possible with silicone, but the results are somewhat more ‘natural’ looking and feeling. Silicone, because it’s less expensive, has an appeal among guys who are trying to get to extreme ‘circus sideshow’ sizes. I know of a guy, for example, with an 11.5” girth, thanks to silicone — achieving the same results with fat grafting would be prohibitively expensive for almost anyone.